Loh K C, Shlossberg A H
Department of Medicine, Dalhousie University, Halifax, Canada.
Ann Acad Med Singap. 1996 Nov;25(6):886-9.
We report a case of a large macroprolactinoma in a 44-year-old male photographer who presented with affected colour perception and a central scotoma of the right eye. An initial computerised tomographic (CT) scan showed an enormous mass lesion extending from the nasopharyngeal area to the third ventricle, with destruction of the skull base. The initial serum prolactin level was 29 180 micrograms/L (normal < 15.8 micrograms/L) while other pituitary hormones were within normal ranges. The patient was treated with oral bromocriptine with prompt resolution of visual defects while significant reductions in tumour size (> 50%) and prolactin level (> 99%) were achieved over a one-year period. This represents one of the highest serum prolactin levels reported in the literature in a patient with a prolactin-secreting pituitary tumour and illustrates the remarkable efficacy of dopamine agonist therapy in patients with large macroprolactinomas.
我们报告一例44岁男性摄影师的大泌乳素瘤病例，该患者出现色觉异常和右眼中央暗点。最初的计算机断层扫描（CT）显示一个巨大的肿块病变，从鼻咽部延伸至第三脑室，伴有颅底破坏。初始血清泌乳素水平为29180微克/升（正常<15.8微克/升），而其他垂体激素在正常范围内。患者接受口服溴隐亭治疗，视觉缺陷迅速缓解，同时在一年时间内肿瘤大小显著缩小（>50%），泌乳素水平显著降低（>99%）。这是文献报道的泌乳素分泌型垂体瘤患者中最高的血清泌乳素水平之一，说明了多巴胺激动剂疗法对大泌乳素瘤患者具有显著疗效。
